title: Rhythm-symptom correlation in patients on continuous monitoring after catheter ablation of atrial fibrillation.
abstract: BACKGROUND
  Correlation between symptoms and atrial fibrillation (AF) episodes after catheter ablation may have clinical relevance, especially for anticoagulation usage. The aim of our project was to analyze the relationship between symptoms and AF recurrences in unselected patients following AF catheter ablation during long-term follow-up.
  
  
  RESULTS
  One hundred and forty-three consecutive patients (mean age 59 ± 9 years, 85% male) were implanted with a continuous cardiac monitor (RevealXT, Medtronic Inc., Minneapolis, MN, USA) following first pulmonary vein ablation procedure. Device data were downloaded every 3 months and correlated to patients' symptom diary. AF was paroxysmal in 55% and persistent in 45%. At a mean follow-up of 14 ± 6 months, 98/143 (69%) patients had at least one AF recurrence. Among these, 53 (54%) reported AF-related symptoms while 45 (46%) were totally asymptomatic. Conversely, 13 (29%) out of 45 patients without AF recurrences reported symptoms. Globally, a significant reduction of symptoms (from 82% at baseline to 44% at last follow-up; P < 0.0001) was observed. SF-12 questionnaire showed a significant improvement of physical and mental functioning (respectively 44.5 ± 8.5 vs 51.0 ± 6.7, and 45.7 ± 9.3 vs 49.2 ± 6.1, P < 0.05 baseline vs last follow-up). At the 12-month follow-up, 80% and 77% of patients were on AAD and anticoagulant drugs, respectively. There were not differences in AAD usage in symptomatic and asymptomatic patients.
  
  
  CONCLUSIONS
  Continuous ECG monitoring is a valuable tool for long-term follow-up after AF catheter ablation facilitating reliable assessment of symptomatic and asymptomatic AF episodes. This may have clinical implications with regards to anticoagulation therapy in high-risk patients.
authors.affiliation: S. Camillo Hospital, Rome, Italy; Centro Cardiologico Monzino, Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Tondo
authors.forename: M
authors.initials: M
authors.lastname: Tritto
authors.forename: M
authors.initials: M
authors.lastname: Landolina
authors.forename: Pg
authors.initials: P
authors.lastname: DE Girolamo
authors.forename: G
authors.initials: G
authors.lastname: Bencardino
authors.forename: M
authors.initials: M
authors.lastname: Moltrasio
authors.forename: A
authors.initials: A
authors.lastname: Dello Russo
authors.forename: P
authors.initials: P
authors.lastname: Della Bella
authors.forename: E
authors.initials: E
authors.lastname: Bertaglia
authors.forename: A
authors.initials: A
authors.lastname: Proclemer
authors.forename: V
authors.initials: V
authors.lastname: DE Sanctis
authors.forename: M
authors.initials: M
authors.lastname: Mantica
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D015716:Electrocardiography, Ambulatory / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011182:Postoperative Care / Q000379:methods; D012008:Recurrence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D063189:Symptom Assessment; D016896:Treatment Outcome
keywords: antiarrhythmic drug; atrial fibrillation; continuous ECG monitoring; pulmonary venin ablation; symptoms